HomeMy WebLinkAbout2708 Redwing Rd - Applications/Plumbing - 07/01/2013FromAR 'ROOTER
970 344 1707 07/01/2013 04:48 #340 P.001/001
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, ro 80524 I
®� Phone 97041616-2740 Fax 224-6134 '�
OVER-THE-COUNTT'ER P MITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all appl" ble inform tion on the application. Incomplete applications will not be accepted.
Application # ILA (-W5 77c$f Date
For offlce use only
Job Site Address (required) Value of Construction (labor, materials, profit)
Property Owner Name
Address
City/State Zip
Phones'70
1
l
Applicant Name
Address
ity/State Zip
Phone
Contractor Lic #
Address
City/State Zip
Phone l 76 "
i I t, /".
y . t _
i �f 1-1 ;1k1 U f: .c l' C , �': Ji sZ5- 2
Contractor City of R. Coll' s Sales Tax #
4e you paying taxes here or by report?
❑ Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? UrResidential ❑ Commercial
If residential, is it: L�KSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes •QXVo If yes, you may need to contact Historic Preseruatlon
If this is for a demolition permit, what year was the'bullding constructed?
If prior to 1975, you cal// need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber Mechanical Roofer Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
permit is not valid until it has been paid and issued. _
Applicant: `` �' r, %
Print Name�J�:"� � l �'l' Signature '� Date !